Although lack of access to appropriate antibiotics is an equally important problem in many developing countries, the increasing incidence of AMR is a huge impediment to the treatment of severe infections. In addition, with the high connectivity between countries and continents, spread of highly resistant bacteria is an increasingly observed problem. The potential for severe public health and financial implications are well recognized [
3]. Several initiatives are trying to tackle the multitude of problems identified above. To prevent further spread of artemisinin-resistant falciparum malaria in Southeast Asia, malaria elimination programs have been initiated in the affected countries. The International Nosocomial Infection Control Consortium (INICC) is a global academic network working to reduce the number of healthcare-associated infections, particularly in critical care (
http://www.inicc.org/). In Vietnam, the VINARES project has introduced ICU microbiological surveillance with a focus on quality management, and stricter treatment guidelines [
14]. Use of biomarkers such as procalcitonin for de-escalation of antibiotic therapy in ICU should be evaluated in resource-poor settings [
15]. The World Health Organisation (WHO) has launched a “Clean Care is Safer Care” programme [
11], and recently compiled recommendations for prevention of HAI in countries with variable economic constraints. (
http://apps.who.int/medicinedocs/documents/s16355e/s16355e.pdf). Even in settings with very limited resources, hygiene measures such as simple hand washing with clean water and locally made soap should be implemented. IPC implementation requires education, training, and time investment of healthcare providers at all levels, while strong commitment from policy makers and healthcare facility management is important. Antimicrobial stewardship should be promoted. A setting-adapted pharmacist-driven program across 47 South African hospitals resulted in a large reduction in antibiotic use, and warrants wider implementation [
16]. Global ICU registries are needed to capture HAI and their associated mortality. Microbiological capacity at sentinel sites should monitor local resistance patterns, and the aggregated data should be formally reported as recommended by the WHO Global Antimicrobial Resistance Surveillance System (
http://www.who.int/drugresistance/surveillance/glass-enrolment/en/). Institutions from high-income countries could help in building microbiological capacity. Investment in intensive care with invasive techniques without considering the prevention of nosocomial infection in LMICs could potentially do more harm than good. Policy makers in LMICs need to evaluate investment in prevention of nosocomial infections against other healthcare investments.